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    Going big with VASER

    Dr. WienerChicago-based plastic surgeon Gregory Wiener, M.D., still uses traditional liposuction and fat transfer when doing fat transfers to the face. But he says a variation to the traditional approach using the ultrasonic VASER (Valeant Pharmaceuticals) device is a better option for larger fat transfer cases, such as to the buttocks or breasts.

    Dr. Wiener, who has no conflicts of interest with Valeant, says there are distinct advantages of using the VASER for specific body parts.

    While providers using the VASER will start by injecting tumescent fluid just like they would with traditional liposuction, the second step differs. There’s an added step using ultrasound.

    “With the VASER, rather than suctioning right away, you’re basically going to use a type of cannula at that point. And that cannula is an ultrasonic cannula, so it doesn’t suction anything. It’s basically a cannula with a tip that vibrates at a very high frequency,” Dr. Wiener says. “VASER has designed these tips with different numbers of rings on them, so, a single-ring cannula focuses the energy forward, and it’s more for tunneling. As you add more rings, the energy is focused more to the sides. So, it breaks up the fat more than just tunnels.”

    You typically start down at the deep plane of fat, just above the muscle fascia, gently moving the cannula back and forth through the fat, according to Dr. Wiener.

    “It’s, overall, a much gentler procedure, I believe, than liposuction. We’re just going to gently move the cannula through the tissues. And you can definitely feel the fat breaking up and falling away from the tip of that cannula as it advances through the tissue,” he says.

    Related: Fat grafting without centrifugation

    The advantage, here, is that you can treat the areas more efficiently.

    “I’ve removed naturally more fat this way because the energy gets into all the nooks and crannies. You’re actually not damaging connective tissue. The septae that hold the skin onto the muscle and the small capillaries and small nerves that run through the tissue incur less damage than with traditional liposuction,” he says. “It’s not like your typical liposuction where you’re going back and forth rapidly after the fat.”

    Based on their experience and comfort levels, surgeons can use the approach to treat not only the deep tissue, but also the mid fatty level and certain areas closer to the surface.

    Patient shown before and after a Brazilian Butt Lift using the VASER liposuction technique on the abdomen, upper and lower back and waistline, and then transferring the fat to the buttock. Photos courtesey Gregory Wiener, M.D.

    Now it’s time to suction out the treated fat, he says.

    “Once you’ve lost treatment resistance with the VASER cannulas, then you go through with a regular liposuction cannula of your choice. And that’s typically not going to be an aggressive cannula. It doesn’t have to be a multi-holed cannula or anything with real sharp edges,” he says.

    While the VASER adds some time to the procedure, it’s less traumatic for the patient and more efficient than regular liposuction, Dr. Wiener says.

    “It’s fantastic in areas where there is lots of real fibrous tissue,” he says. “I love it at the lower back and waistline, because I can really contour that area much better than with regular liposuction. Men’s fat in the love handle area tends to be a little tougher — a little more fibrous. And in those areas I think this machine excels.”

    Dr. Wiener, however, isn’t convinced about claims that ultrasonic liposuction contracts skin better than traditional lipo. From what he has seen, skin contraction is similar to that from regular liposuction.

    NEXT: Tips for Fat transfer

    Lisette Hilton
    Lisette Hilton, president of Words Come Alive, has written about health care, the science and business of medicine, fitness and wellness ...


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